Clinical Case: Pneumoperitoneum Due to Sexual Activity

A 27 yo CF is admitted to the hospital with CC: periumbilical abdominal pain and fever for 2 days.

PMH:
cholelithiasis

SH:
Smoker, IVDA - heroin, uses cocaine. Failed several rehab programs.

Physical examination:
VSS
Chest: CTA (B)
CVS: Clear S1S2
Abdomen: Soft, diffuse tenderness, no rebound, ND, +BS
Ext: no c/c/e

She spiked fever and a CXR was ordered as part of the fever work-up.